May 2018

New Industry Roadmap Recommends Path Toward Sustainable Provider Data System

May 2018

The Provider Data Action Alliance (PDAA), a diverse group of 20 healthcare leaders convened by CAQH, has released a roadmap outlining recommendations to address provider data issues impacting healthcare providers, patients and health plans. The industry spends $2 billion annually to maintain provider data, yet errors and inefficiencies remain, disrupting many crucial processes in the healthcare system.

An Industry Roadmap for Provider Data” outlines a core set of principles that can guide the development of an industry solution, a model for what the provider data system should look like and a plan to implement the vision and ensure industry support.

CAQH Named One of the Best Places to Work in Healthcare for Third Consecutive Year

May 2018

Modern Healthcare Best Places Award 2018

Modern Healthcare recognized CAQH on its list of the Best Places to Work in Healthcare for 2018. This is the third year in a row that CAQH has been included on the list of 150 organizations and companies across the U.S. that “stand out in their efforts to create an empowered and satisfied workforce.”

Other News


Upcoming Webinars


Streamlining Healthcare Business Transactions: Results from the 2017 CAQH Index

June 14, 2018 | 2:00 PM – 3:00 PM EDT

For nearly two decades, the U.S. healthcare industry has been working to automate time-consuming phone, fax and mail claims-related business transactions. The annual CAQH Index tracks the progress of this transition.

How much progress did the latest CAQH Index find? CAQH will release the 2017 CAQH Index in a webinar on Thursday, June 14, at 2 pm ET.



Is CAQH ProView Right for Your Dental Plan?

July 10, 2018 | 2:00 PM – 3:00 PM EDT

This hour-long webinar will feature a national dental plan that has successfully used CAQH ProView – in partnership with the American Dental Association – to shift their network dentists to more efficient electronic credentialing applications. Their experience can help your plan decide if this Solution is right for your dental plan.



Recent Webinars - Recordings Available


The Midday Download: A Tale of Three Credentialing Departments - How Health Plans are Achieving Their Primary Source Verification Objectives Despite Limited Automation

The hub of an efficient primary source verification (PSV) process is automation. However, for many health plans, mechanizing data extraction, evaluation and categorization may be delayed due to competing departmental priorities, cost and limited IT resources.

During this 20-minute discussion review how three health plans changed their processes to meet the immediate demands of larger provider networks and tighter deadlines without hiring additional staff or building a fully automated process - while still setting the stage for future automation.  

Watch the on-demand webinar recording here.


Value-based Payment Webinar Series: Dr. Kate Goodrich, Director of the CMS Center for Clinical Standards & Quality - The Role of Interoperability in Value-based Payment

Interoperability challenges are a pressing problem across healthcare. For those implementing value-based payment models, they are greatly magnified. The Centers for Medicare and Medicaid Services (CMS) is working to ensure the appropriate technology and regulatory structure exists to support value-based care.

Watch this recording to learn about the focus of CMS on interoperability and how it will impact the overhaul of meaningful use rules for Certified Electronic Health Records Technology (CEHRT) to reduce administrative burden. Hear about future proposals to reduce the number of required EHR quality measures and thresholds to minimize provider burden.

Watch the on-demand webinar recording here.



CAQH CORE Town Hall webinars provide the public with an update on CORE's recent activities related to industry development and/or implementation of healthcare operating rules. Learn about federally mandated and voluntary CAQH CORE Operating Rules, voluntary CORE Certification, and much more.

Watch the on-demand webinar recording of the most recent CAQH CORE Town Hall here.


CAQH on the Road


CAQH will be exhibiting and speaking at the following event:


AHIP Institute & Expo

June 20-22, 2018, San Diego, CA

Interested in learning more about CAQH CORE or CAQH Solutions? Visit us at booth #708. 

Want to hear about the latest in provider data research? Come to our breakfast session on Thursday, June 21, from 7:15 - 8:15 am. Atul Pathiyal, Acting Managing Director of CAQH Solutions, will discuss how to solve the provider data dilemma with Michael Dowling, Chief Administrative Officer at Montefiore Care Management, and Benjamin Holliday, Director of Provider Data Management at Blue Cross Blue Shield of Tennessee.


New CAQH Staff


Taahaa Akram, Business Analyst

Taahaa is the newest member of the CAQH ProView Business Analysis team. His past contracting organizations included Coventry Healthcare, Care Source and Kaiser Permanente.

Paul Bailey, Director, Technology Infrastructure

Paul is responsible for the entire Technology Infrastructure (computer, storage and network) supporting CAQH Solutions. He has spent several decades in IT and most recently worked as the Director of Infrastructure Operations for Kaplan Higher Education.

Rebecca Beattie, Senior Manager, Product Marketing

As a member of the Marketing and Communications team, Rebecca is responsible for promoting a portfolio of CAQH Solutions. She joins CAQH from Knowledge to Practice, a supplier of online, continuing education content for healthcare providers, where she was Director of Marketing.

Ruth Buenaflor, Senior Manager, Client Implementations

Part of the CAQH Solutions Operations team, Ruth is helping health plans with DirectAssure implementation. She spent the last seven years as a healthcare consultant filling various roles such as Product Manager, Interface Implementation Engineer and Client Relationships Manager.

James Schlackman, Manager, Desktop Support

James is providing internal IT support for CAQH, based on his extensive background of managing IT at multiple locations and using a mix of internal and contracted resources. His most recent position was as Director of Technology for the Charles E. Smith Jewish Day School where his team supported over 900 workstations.

Lindsay Wilcocks, Account Manager

The newest account manager, Lindsay will initially focus on supporting clients that have CAQH ProView, SanctionsTrack and/or DirectAssure. Lindsay spent the past three and a half years as a healthcare account manager at the Advisory Board.


CAQH in the News


7 recent RCM tips, Becker’s Hospital Review

Prior Authorization’s Pain Continues for Providers, MedPage Today

Health Plan Data Governance Assists Value-Based Reimbursement, HealthPayer Intelligence

Uniform Operational System Key to Value-Based Payments, CAQH Says, RevCycle Intelligence

CAQH identifies key opportunities to improve value-based care, FierceHealthcare

Achieving health care’s best future means getting fundamentals correct now, The Hill

Top Ways to Streamline Value-Based Payment Models, Managed Healthcare Executive

Best Places to Work in Healthcare – 2018, Modern Healthcare

Assessing Providers for Participation in Value-Based Care Contracts, HealthPayer Intelligence

How Can Payers Get Providers to Use Electronic Payment Systems?, HealthPayer Intelligence